What are the responsibilities and job description for the BILLING SPECIALIST position at Dialyze Direct?
Description
The Billing Specialist is responsible for timely, complete, and accurate claims submission to third party insurance carriers. They ensure that each claim has active and accurate insurance information, authorizations in place (as needed) and billing and coding requirements are met to send a clean claim on first submission. The Billing Specialist utilizes their in-depth knowledge and understanding of Clearinghouse responses to analyze, research, and resolve claim errors and rejections in a high-volume environment.
Responsibilities :
Clean Claim on First Submission (70%) :
- Ensures required patient demographic information is accurate and complete.
- Ensures insurance information is active and accurate prior to releasing claims.
- Ensures prior authorizations are active and accurate prior to releasing claims. Re-verifies and obtains new authorizations as needed.
- Ensures claim meets all payer billing and coding requirements prior to releasing claims.
- Ensures all charges and treatments are captured prior to releasing claims.
- Releases claims via the Clearinghouse for processing by third party insurance carriers.
- Prepares paper claims when required for submission by primary and / or secondary payers.
Claim Errors and Clearinghouse Rejections Resolution (30%) :
Requirements :
Benefits :
Depending on your job status, you may be eligible for the following benefits :
Compensation :
Compensation offers are based on education, experience, skills, and geographic region.
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